ABSTRACT
Topical corticosteroids have been prescribed widely in the treatment of inflammatory and autoimmune dermatoses. As vitiligo is considered to be an autoimmune disease that results in melanocyte destruction, topical corticosteroids are the first line of therapy, especially for localized cutaneous and mucosal variants, as they suppress the vitiliginous cytokine milieu. Interestingly, they have been seen to be most effective in the presence of active Koebner's phenomenon. They have been shown to be effective in only 57% of adult patients and 64% of childhood vitiligo patients. Moderately potent topical corticosteroids should be prescribed for the face, and potent and ultrapotent steroids should be reserved for body lesions. The high incidence of adverse effects is a concern that warrants counseling at initiation and careful monitoring of therapy. The selection of correct preparation and vehicle of delivery will also aid in increased tolerance and compliance with therapy.
